A child with a retropharyngeal abscess deteriorates rapidly with respiratory distress and signs of mediastinitis. Infection reached the posterior mediastinum through which anatomical continuation of the retropharyngeal space?

• A Parapharyngeal space lateral to the pharynx
• B Pretracheal space anterior to the trachea
• C Danger space between the alar fascia and prevertebral fascia ✓
• D Submandibular space below the mylohyoid

Explanation

Between the buccopharyngeal fascia and the alar fascia lies the retropharyngeal space proper, but behind the alar fascia and in front of the prevertebral fascia lies the danger space, sometimes numbered space four. It extends from the skull base down to the diaphragm, so infection can descend freely into the posterior mediastinum. The pretracheal space reaches the anterior mediastinum instead, and the parapharyngeal and submandibular spaces do not communicate with the chest.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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